A common question my patients ask me is how to disclose to family and friends that they are experiencing depression. My patients report that family and friends typically respond in one of two ways: they are overly helpful and supportive, repeatedly asking the person, “How are you feeling?” “How are you doing?” Or, they are unsupportive and unsympathetic, “What do you have to be depressed about?” “Cant you just snap out of it?” For a person already feeling depressed, neither of these responses are particularly helpful, and can only exacerbate the sadness, loneliness and despondency that the person was already feeling. If you are experiencing depression and have decided to talk to close friends and family members about how you are feeling, it is important to take control of the situation. Others will respond based on your delivery of the information. Keep the following tips in mind: 1. Who should I tell? If you are experiencing depression, there are certain people in your life who probably have already suspected that something was going on. Maybe they noticed a change in your mood, interests or energy level. It is an easier conversation to have when the person is already aware of the fact that you are experiencing something. It is also helpful to decide who you think would be the most supportive, and talk to them first. 2. Personalize the experienceExplaining how you are affected by depression can help the person understand how you are feeling. Depression affects everyone differently. Describing your specific symptoms may convey the severity of your experience. For people who have never experienced depression, they may not understand how the symptoms manifest. Letting them know that you are not just feeling bad, but also have no energy, have lost your appetite and lost your interest in daily activities can be helpful. For example, say, “Some days I just cant get out bed,” or “I’m plagued by negative thoughts in my head all day.” 3. Share your treatment strategyLet the person know what you are doing to help yourself feel better. Maybe you are attending psychotherapy, group therapy or are considering medication. The other person may be relieved to know that you have identified the symptoms and that you are actively treating them. It is a good idea to have someone who can help monitor symptoms, particularly in the event that they worsen in frequency or severity. Additionally, they may also be helpful in keeping you motivated to attend appointments. 4. Let them know how they can, and can’t, helpThis is the most important point. Let the other person know specifically what they can do that would be helpful to your treatment and recovery. Should they call you and check in? Do you need help from time to time with errands when you are feeling tired or overwhelmed? Most people forget that it is just as important to let them know what you would not find helpful. Oftentimes, my patients tell me that they do not want to be asked how they feel. Is this on your “do not do” list? Consider your phrasing carefully. You may tell the person, “please don't ask me repeatedly how I am feeling, I would rather you be available to talk to me if I reach out to you, such as when I’m feeling down.”Another patient of mine repeatedly complained that she felt like she was treated differently because of her depression diagnosis. She hated feeling like people were “walking on eggshells around her.” If this is how you feel, it is important to communicate that to family and friends. While telling someone whatnot to do may feel like an uncomfortable conversation, it is better to think of it in terms of letting the other person know exactly what you need. Remember, you chose to tell this person because you believed they would be supportive; they want to know how they can help you. 5. What if they are not supportive?There is still a very real possibility that despite your best efforts, the person you have confided in is still not supportive of your struggle. Some people will still respond with, “its all about will-power,” or “you have to focus on the positive.” This type of individual will only serve to exacerbate your sadness and add to your frustration. There are several options for next steps:- Provide some psychoeducation. Oftentimes, people are not supportive to someone’s plight with depression because they lack education. They have ill-conceived notions about the illness and outdated information; basically, their opinions are not based on psychological fact or theory. Try giving them pamphlets or informational brochures from your psychologist’s office, or print some up-to-date information about the course and treatment of depression from websites such as The American Psychological Association (www.apa.org), National institute of Mental Health (www.nihm.nih.gov) and National Alliance on Mental Illness (www.nami.org).- Realize it’s their issue, not yours. There are some people who simply cannot understand the neurobiological mechanisms of depression, and no matter what, will not be empathetic or supportive. As difficult as this may be, it is important that this does not become an additional stressor or source of frustration. Remind yourself that there may be reasons why this person cannot be there for you: are there in denial? Are they experiencing their own depressive symptoms? A difficult decision for you to make may be deciding to put distance between you for the time being, so that you can focus on your mental health and not allow any more negativity to contribute to your mood. Keep in mind that according to the Center for Disease Control and Prevention, from 2007-2010, 8% of Americans over the age of 12 were diagnosed with depression. That means there are approximately 2.5 million people who understand how you feel. Remember, there are people who will listen, who will help and who will be supportive. Reach out to your counselor or therapist if you are having a difficult time either disclosing your depression, or are uncomfortable with the outcome of the conversation.